title: Assessing the spreading patterns of dengue infection and chikungunya fever outbreaks in lower southern Thailand using a geographic information system.
abstract: OBJECTIVE
  The aims of this study were to assess the incidence of dengue infection (DEN) and chikungunya fever (CHIK) and determine the direction and speed of CHIK between August 2008 and June 2009 in lower southern Thailand.
  
  
  METHODS
  The National Communicable Disease Surveillance System database and a geographic information system containing data on case locations were combined. R and ArcView were used for identifying incidence, direction, and speed of disease outbreaks.
  
  
  RESULTS
  A total of 27,166 patients were identified, of which 3319 and 23,847 had DEN and CHIK, with incidences of 73 and 521 per 100,000, respectively. The direction of the CHIK outbreak moved from south to north with a median speed of 7.5 km per week. CHIK cases increased after 6 weeks of increasing cumulative rainfall with variation of average daily temperatures (23.7-30.7 degrees C) per week. There was no clear association of DEN with climate variables.
  
  
  CONCLUSIONS
  The combination of surveillance and geographic information system data of DEN and CHIK can be used to determine the speed and direction of disease spread. DEN is endemic, but CHIK is an emerging disease. Because of the rapid spread of CHIK, strict and timely integrated vector control programs after case notification must be implemented.
authors.affiliation: Office of Disease Prevention and Control 12, Muang District, Songkhla, Thailand. pookdit@hotmail.com
authors.forename: Thanittha
authors.initials: T
authors.lastname: Ditsuwan
authors.forename: Tippawan
authors.initials: T
authors.lastname: Liabsuetrakul
authors.forename: Virasakdi
authors.initials: V
authors.lastname: Chongsuvivatwong
authors.forename: Suwich
authors.initials: S
authors.lastname: Thammapalo
authors.forename: Edward
authors.initials: E
authors.lastname: McNeil
mesh_terms: D000293:Adolescent; D000328:Adult; D018354:Alphavirus Infections / Q000453:epidemiology; D065632:Chikungunya Fever; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011159:Population Surveillance; D011891:Rain; D013696:Temperature; D013785:Thailand; D055815:Young Adult